Diverticulitis: Causes and Treatment

In the United States, the cases of diverticulitis are frequent when patients suffer from pouches in their digestive system. Annually, about 180 out of 100,000 people are diagnosed with this condition, including those who are older than 50 years, women, and whites (Swanson & Strate, 2018). Its symptoms include abdominal pain, fever, nausea without vomiting, and white blood cell elevation. Doctors diagnose diverticulitis during a physical examination that contains the examination of vital signs, blood, urine, and stool, as well as scanning. Treatment depends on the severity of the condition, starting from antibiotics and ending with surgery. In this presentation, the case of a 76-year-old man who came in for an abdomen and pelvis MRI is analyzed.

The diagnosis of diverticulitis is a complex process that is explained by the presence of symptoms that may be inherent to other diseases. Therefore, the choice of diagnostic techniques plays a critical role, including the offered positioning and technical aspects. In the case under consideration, magnetic resonance cholangiopancreatography (MRCP), as a type of magnetic resonance imaging, was used to obtain detailed images of the digestive system. The patient was placed on the table (supine position) with receiver imaging coils being arranged around the necessary body parts. Additional recommended techniques are colonoscopy, ultrasound, and computer tomography (CT).

CT is one of the common imaging modalities that can be offered to patients with suspicion of diverticulitis. At the same time, Swanson and Strate (2018) identified MRI and ultrasound as useful alternatives to gather enough information and identify all the necessary symptoms. In this case, MRI with 16 ml MultiHance injection was used to identify lesions with abnormalities. Biernacka, Barańska, Grzelak, Czkwianianc, and Szabelska-Zakrzewska (2019) compared different techniques to determine inflammatory processes and recommended it as the one with no radiation and a variety of contrast agents. MRI is a non-ionising modality where radio waves and magnetic fields create the required images and compared normal and diseased tissues. More than 4 hours are necessary to prepare a patient for this procedure because fasting is an obligatory detail.

Despite a number of complex features and details of MRI and its impact on patients, its working process is rather simple. There are several powerful magnets in the equipment that are responsible for the creation of a magnetic field. Protons in the body are stimulated and align with the field. As soon as radiofrequency fields disappear, MRI sensors detect the released energy and introduce the environment under analysis. Contrast agents are used before the MRI to control the speed of protons (the faster their speed is, the brighter the images are) (Biernacka et al., 2019). Although there is no risk of radiation with MRI, this technique is still dangerous because of the presence of the magnet. Therefore, patients with implanted stimulators, pacemakers, and other devices cannot be scanned. Radiofrequency energy may also provoke the body’s overheating, which is also dangerous for people.

References

Biernacka, K. B., Barańska, D., Grzelak, P., Czkwianianc, E., & Szabelska-Zakrzewska, K. (2019). Up-to-date overview of imaging techniques in the diagnosis and management of inflammatory bowel diseases. Przeglad Gastroenterologiczny, 14(1), 19-25.

Swanson, S. M., & Strate, L. L. (2018). In the clinic: Acute colonic diverticulitis. Annals of Internal Medicine, 168(9), 65-80.